After hip replacement, the patient will have to completely reconsider their lifestyle, but there is no need to despair, the rehabilitation period and some restrictions are not terrible. Many patients want to know what rules to follow after surgery. A large number of reviews from lucky people who have had a joint replacement will encourage those patients who are just about to start life again.

When the operation is over

After hip replacement, with proper rehabilitation, the patient will forget about that unbearable pain and will be able to move as before, before problems with the hip joint - that is, he will be able to live without problems. The main thing is to adhere to some rules.

In reanimation

A patient who has just undergone surgery spends several days in the hospital, with the first day in the intensive care unit or intensive care unit. Before the operation, he will be instructed on what needs to be done immediately after the anesthesia wears off, and what is strictly prohibited.

1. It is necessary to perform special breathing exercises.
2. Do not try to roll over under any circumstances.
3. Perform micromovements with your toes and the entire foot every 15-20 minutes.

The problematic limb will be dressed in a derotation boot, a special rigid orthosis that does not allow the foot to turn inward or outward. This eliminates the reduction of the hip.

The limbs are bandaged with elastic bandages from the groin to the fingertips in order to prevent the development of thromboembolism - the bandage narrows the vessels of the lower extremities, preventing their blockage.

3 days after surgery

After the patient is transferred to a regular ward, he needs to perform a therapeutic set of exercises under the supervision of a specialist several times a day. You should also make sure that the operated limb is not in the same position for a long time - it is recommended to place a pillow or cushion under the knee every 20-30 minutes, and remove it after the same time, so the limb will not suffer from numbness. The orthosis is removed after hip replacement on the third day.

Important! After removing the derotation boot, it is necessary to ensure that the foot is strictly at an angle of 90 degrees relative to the limb.

Gradually, if the doctor does not prohibit, you can make some movements. For example, after removing a boot, you may be allowed to remain in a half-sitting position for a short time. Then you are allowed to sit in such a way that the body is slightly tilted back on the pillow, the hip joint should be higher than the knee.

You can roll over from a lying position onto your stomach or side one week after surgery. In this case, it is necessary to place a pillow on the inner side of the thighs at each turn so that the legs do not move together.

For reference! 7 days after prosthetics, the elastic bandages are removed at night; they should be bandaged in the morning. Instead of bandages, you can use compression stockings for convenience; they must be purchased according to size and degree of compression.

When can you walk?

You can get up under the supervision of doctors 7-8 days after hip replacement. You should not attempt to stand or even walk on your own - the prosthesis can break if used ineptly, and tension in the thigh muscles can cause rupture of blood vessels and other elements. The orthopedist will explain how to properly walk on crutches after endoprosthetics - you can only rest on your healthy leg and orthopedic devices, you can only help with the operated leg.

Walkers with wheels are convenient; they are used at the beginning. After several days of walking with the help of wheeled walkers, they are changed to wheelless ones.

For reference! On the 15th day, the patient is usually discharged home if there are no complications and the stitches are of high quality.

Once the patient gains confidence in movement, usually 2-3 weeks after surgery, the use of crutches is necessary. The most convenient option in such a situation is modern orthopedic devices with ergonomically shaped handles, when the support devices cover the forearms well, the patient needs to focus only on the hands. Walking with crutches lasts for 2-2.5 months, so it is better to choose the most convenient option for the patient.

Important! It is prohibited to turn the body sharply away from the operated limb while walking. Walking is allowed for 20-30 minutes several times a day, and the patient must change the speed of movement.

You should not lean forward too much, as the prosthesis may dislocate due to excessive tension, so you should not lift anything from the floor yourself or sweep up litter with a broom that is too short. In the shower, the lower leg area should be washed with special brushes with long handles. You can sit on high chairs or chairs of moderate softness, but you can no longer tilt your body. Lying on the replaced joint is prohibited.

Important! You cannot take a bath for 6-7 weeks; all hygiene procedures must be performed quickly, preferably in the shower. Hot temperatures can lead to blood clots.

3 months of new life behind

There are many questions about the topic of sex after hip replacement, how many days should pass after the operation? Experts allow sexual intercourse 2-3 months after surgery, by which time the joint will have acquired muscles and ligaments, and movements will be much easier.

After three months, the patient is already firmly on his feet, the muscle corset firmly holds the new joint, all movements are coordinated. Instead of crutches, you can walk with a cane. Here the main selection conditions will be:

• rubber tip to prevent slipping;
• correct height;
• comfortable handle.

Further qualities of the orthopedic product depend on the person’s preferences - you can buy a lightweight metal cane, or a wooden one. When walking with a cane, you need to take into account that the support should be on your healthy leg, so you should hold it with the opposite hand.

For reference! After a three-month rehabilitation course, a person can go back to work, if it does not involve spending a long time in a sitting or standing position.

Sauna lovers can breathe out - after 3-4 months they are allowed to go to the bathhouse or steam room, since the risk of blood clot formation has passed. Also during this period, you can begin to train the operated limb - first stand on it using both hands, then one. If movements are carried out without the help of hands, it is necessary to perform them against a wall or handrail so as not to fall.

Almost healthy!

Full restoration of joint function occurs by 6 months; swimming can be done to strengthen it. But even with a recovered limb, one should not forget about some warnings:

1. You cannot lift or carry loads exceeding 2-3 kg. When carrying things, the load should be placed on a healthy limb.
2. You cannot drive or sit for long periods of time. It is best to take breaks every 2 hours.
3. You should forget about the “foot-to-foot” position.
4. Turning on the affected leg is prohibited.

During rehabilitation, the person should have already gotten used to such rules, so their further use will not be difficult.

Forecast and reviews

Life with a hip replacement is difficult only in the first months after surgery; in the future, only relief awaits everyone. Patients talk about a difficult emotional state in the first days, when it is uncomfortable to lie down, but then only positive emotions.

I was very afraid of surgery on the hip joint, I thought I would remain disabled. But I overpowered myself, howled with discomfort for the first week, but then I pulled myself together and began to study regularly with specialists. A year has passed - everything is fine.

Victor, 45 years old.

It’s been 3 months since the hip replacement, and I’m now learning how to use a cane. Doctors say the prognosis is favorable. And how much suffering and time was wasted!

Lena, 56 years old.

I just recently had hip replacement surgery, 2 months have passed. It’s difficult, of course, but those pains are gone and I’m moving!

Kirill, 45 years old.

Now that the hip replacement surgery is over, rehabilitation has taken its place. The most important thing now for the patient is to be extremely attentive to his feelings and successfully go through all the stages without causing complications. There is no need to be afraid, they occur infrequently and, as a rule, when a special regimen is not followed, which is prescribed from the first day after surgery. The duration of rehabilitation treatment is approximately 3 months, of which the patient spends 2-3 weeks in the clinic, and the rest of the time he will either continue classes and undergo procedures at a good specialized medical center, or strictly follow the instructions issued at home.

Where is it better to undergo recovery - at home or in a clinic?

After hip replacement surgery, rehabilitation not only in the early phase, but also in the late phase, is also best done under the supervision of an orthopedist and a professional exercise therapy instructor. Why is this so important? In the later stages, you can overestimate your capabilities by starting to put more load on the operated joint than it is ready to accept at the moment, which is fraught with dislocation of the endoprosthesis, loosening and other troubles. Usually this happens in the long term, while at home, when, against the background of a significant improvement in the condition, a person decides that he can already go beyond the limitations. In fact, the final strong bonding of the prosthesis with the bone and muscle structures has not yet taken place, and this occurs no earlier than after 3-4 months, and here is the result.

Why is specialist supervision needed? Because only he is able to convey to the patient the essence of the recovery process. Without outside instructions, even the most disciplined and informed patient is unable to provide rehabilitation.

It is advisable to remain as long as possible under the supervision of specialists who, taking into account the dynamics of recovery and the individual characteristics of the patient, will select the optimal permissible level of physical activity, make adjustments as necessary to increase or decrease them, and monitor the correct execution of each exercise. The rehabilitation instructor and the attending physician will ensure that rehabilitation after hip replacement proceeds without complications, providing the full range of mandatory preventive measures in a timely manner.

During the exercises, something will certainly pull, ache, or hurt, but only a physiotherapist who has had many such patients will be able to clearly explain the reasons and instill confidence.

Wherever the patient undergoes the postoperative plan of mandatory activities, he must strictly adhere to the individual rehabilitation program after hip replacement. It is compiled exclusively by a highly qualified specialist, in accordance with established endoprosthetics standards, for a specific medical case.

Sequence, timing and main features of the stages

Postoperative stages	Intervals by period	Postoperative nature	Physical activity mode And
Early phase	from 1 to 7 days inclusive	acute reactive-inflammatory reaction	early gentle
	from 8 to 14 days	epithelization, contraction, wound healing	light-tonic
Late stage	from 15 days for 6 weeks	beginning of remodeling: predominance of bone resorption	primary restorative
	from 7th to 10th week.	dominance of hard tissue renewal processes	late recovery
	from 11 weeks until 3-4 months have passed from the date of surgery	completion of bone repair adapted to new conditions	adaptive

Orthopedic surgeons strongly advise that you spend 3 weeks after surgery undergoing a treatment and recovery phase in the orthopedic department of a surgical hospital, then for about the same amount of time in a specialized rehabilitation center. After this, to consolidate the results obtained, take a course of health improvement in a resort-sanatorium-type institution specializing in the profile of therapeutic and preventive treatment of the musculoskeletal system.

Early physical rehabilitation

From the information provided in the table, you see that recovery after surgery is not a matter of one week, but on average 3-4 months. Complex patients can recover from six months to a year. So, let's look at what the initial rehabilitation phase is.

Goals and objectives

The principles of recovery after surgery on the hip joints in the initial period are mainly based on the use of balanced kinesiotherapy, gentle static exercises, and myostimulating physiotherapy procedures. In addition, the patient receives competent medical care, including antibiotic therapy, administration of vascular drugs, and antiseptic wound treatment. Thanks to proportionate and targeted exercise therapy and adequate treatment with medications, the following is achieved:

• stimulation of blood circulation in the lower extremities;
• elimination of inflammation, swelling, painful syndrome;
• increasing muscle strength and range of motion in the problem area;
• correction of statics of the spinal sections;
• prevention of postoperative negative reactions (thrombosis, infections, etc.) and development of lasting immunity against all possible consequences.

Compression cuffs are a mandatory measure to prevent thrombosis in the first days after surgery.

Also, from the first day, such a device is used for passive expansion of the joint. Used for both knee and hip.

This period ensures the implementation of one of the most important goals - early activation of the operated patient. A rehabilitation doctor and exercise therapy instructor must teach a person all the norms of physical behavior and confident use of mobility aids; help develop the correct stereotype of walking and taking a sitting position, going up and down stairs. Also, their responsibilities include warning the patient about all types of physical activity that are strictly contraindicated at a given period of time.

Physical mode

• breathing diaphragmatic exercises;
• training a healthy limb through active exercises, as well as flexion/extension of the ankle of the endoprosthetic leg until a feeling of slight fatigue in the lower leg muscles;
• strengthening the gluteal, thigh and calf muscles using isometric tension in the corresponding zones;
• raising the pelvic region, resting on the elbows and foot of a healthy lower limb, in order to prevent bleeding and necrosis of the skin due to their compression due to a long stay in bed;
• from 2-3 days, individualized passive-active training on the leg with a replaced joint is included up to 6 times a day for 15 minutes (raising an even limb, sliding the feet on the bed with pulling the legs towards oneself, bending the knee joint area less than 90 degrees;
• special strengthening exercises for the adductor and abductor muscles, as well as the hip extensor muscles (Hula-Hula, Thomas test, etc.).

After approximately 2 days, the patient is allowed to sit down (sit for no more than 15-20 minutes), while the doctor will prescribe additional exercises performed in a “sitting” position, for example, straightening the leg at the knee joint, holding it in the extension position for 5 seconds (10 sets each). 5-6 times/day). Also, from the third day, the patient begins to get up, stand and walk a little on crutches, not yet transferring body weight to the problem side. The duration of the walk at first is 5 minutes, but the time is gradually added, and by the end of this period you need to walk three times a day for approximately 30 minutes.

A separate area of ​​rehabilitation is ergotherapy, when the patient is taught to care for himself safely: get up and lie down on the bed, put on socks and shoes, other clothes, lift things from the floor, use crutches, etc.

Support on the leg is added very carefully, starting from a small touch of the foot with the floor surface, gradually increasing the percentage of the support load. Having mastered the “standing” position well, the patient, under the guidance of a methodologist, will learn to:

• abduction in the lateral and posterior direction of the straightened leg, holding on to the headboard of the bed, chair or walker, avoiding painful sensations;
• bending the knee while pulling the heel towards the buttocks, straining the gluteal part;
• controlled transfer of weight from one leg to another, from side to side, etc.

Precautionary measures

You already know how long rehabilitation takes after hip replacement of the musculoskeletal system, and that in the early stages the musculoskeletal frame of the body is too weak. Therefore, to avoid displacement of the functional components of the endoprosthesis (dislocation) or instability in the places of attachment of the artificial hip joint, strictly follow the instructions below.

1. Do not exceed the amplitude of hip flexion more than 90 degrees, especially with its internal rotation and adduction.
2. You cannot apply a full axial load to the prosthetic segment. This is dangerous due to loosening of the implant.
3. Do not sit on chairs, sofas, or beds with low surfaces. The corresponding furniture must be high enough.
4. Avoid vigorous and forced movements in the joint both during self-care and during rehabilitation physical therapy. Forget about the “leg over leg” position, this position is strictly prohibited for at least 4 months!
5. During classes aimed at restoring the hip joint after total hip replacement surgery, be careful to ensure that your legs do not come close to each other or cross each other.
6. Do not take any medications that have an analgesic effect immediately before exercise therapy or during exercise. They powerfully suppress pain sensitivity, which is why you lose control over your own sensations during physical activity, which can greatly harm the operated leg.
7. Do not lie on the problematic side either during sleep or during normal rest. Rest on your unaffected side using a bolster or small pad between your two limbs. They will protect you from sudden unsuccessful movement, which can disrupt the congruence of the joint elements of the endoprosthesis. It is preferable to sleep on your back at first, and do not forget to place a demarcation pillow between your legs.

A cushion between the legs is a mandatory requirement for a month after surgery. Crossing your legs increases the risk of implant dislocation.

How long the early cycle rehabilitation will last after a hip replacement is decided only by the doctor on an individual basis. If all goals and objectives are achieved in full, well-being meets the deadlines, recovery is progressing according to plan, then the patient is transferred to the next stage - the longest and no less responsible.

At an angle of less than 90 degrees in the hip joint, this risk is also high.

Late stage recovery system

About 3 weeks have passed since the hip replacement was performed, rehabilitation is becoming more varied, longer in time and intensity. The specialist adds to the established physiotherapeutic treatment, namely electrical myostimulation and ultrasound, more procedures for musculocutaneous microcirculation and optimization of osteoreparation processes:

• medicinal calcium electrophoresis, possibly bischofite;
• infrared laser therapy;
• balneological treatment;
• acupuncture;
• paraffin therapy and ozokerite applications;
• massage of the lumbosacral spine and healthy leg.

There is nothing better than a swimming pool for recovery, but do not forget that the seam must heal before that!

Physical therapy consists largely of dynamic exercises, resistance training and weight training. The patient, under the supervision of a methodologist, performs a varied complex of exercise therapy on special simulators, as well as using sports equipment, for example, a rubber band, light weights, a step platform, and block equipment.

Suspension work is a great way to engage your deepest muscles.

Main goals of the later period

The fundamental goals at this stage are the physical development of the lower limb until full functionality is reproduced in it, work on gait and posture, and improvement of the ligamentous-muscular center. The basis of measures to implement the assigned tasks is again kinesitherapy. Physiotherapy is not canceled; after hip joint replacement, it is given an equally significant place in rehabilitation. So, now all treatment and rehabilitation measures are aimed at:

• the maximum possible expansion of the motor-support functions of the limb, achieving absolute stability of the hip joint and full range of movements;
• regulation of muscle tone to normal, increasing muscle endurance;
• practicing symmetrical musculoskeletal work of both legs;
• correction of opportunistic habits when moving, which the patient was forced to follow before and after surgery due to motor incompetence and fear of pain.

As before, the rehabilitation instructor works with the ward to adapt to a new lifestyle, to develop sustainable movement patterns that he will use during self-care, when doing housework, and also outside the home.

Nordic walking is good for its safety.

It is important to understand that the effect will not occur immediately and on its own after a complex operation on the musculoskeletal system. How rehabilitation will proceed and how long it will last after hip replacement will be significantly influenced, first of all, by the adequacy of the type, frequency, intensity and duration of daily physical activity given to the joint. The effectiveness and approach of recovery are influenced by the patient’s diligence in relation to medical instructions, overcoming his own laziness, weakness and fear.

Attention! It is important to understand that the hip joint has been replaced with an artificial organ. Yes, this is an analogue organ that coincides with the configuration and functional parameters of the anatomical and physiological unit, but in any case it is not a biologically native element. In order for the “new” part of the musculoskeletal system to become an inextricable link in a single locomotor chain, harmoniously coordinated with all anatomical structures, which is a rather complex process, it takes time and a therapeutically competent, targeted effect on the prosthetic leg.

Balance exercises of a later period are suitable for those who want to get the maximum from the treatment provided.

Walking is now increased in duration to 60 minutes, and in frequency - up to 4 times a day. After 1.5-2 months, perhaps a little earlier or later, the supervising doctor will stop using crutches, allowing you to use a cane when moving. The cane is used until complete restoration of the operated area is confirmed. Usually it is canceled and allowed to do without any support at all between 13 and 17 weeks.

Basic complex of late exercise therapy

The number of repetitions of one type of exercise is 6-10 times, the cyclicity of the complex is 2-3 times a day.

Before using gymnastics techniques, consult your doctor to make sure that none of the exercises has contraindications for your medical problem.

Rehabilitation after total joint replacement with an endoprosthesis at this time also includes cycling and aqua gymnastics. In addition, the patient will find it very useful to swim in the pool in the front crawl style. But do not forget about the gradual transition to new types of physical education techniques and a reasonable increase in the tempo, strength and time of recovery exercises. At periods such as 3, 6 and 12 months, it is necessary to undergo a mandatory control and diagnostic examination at the clinic.

Advice! If it’s too far for you to go to the pool, it’s winter outside and you can’t do much walking, and an exercise bike takes up a lot of space, then buy a step machine. This is an incredibly effective exercise for training the lower extremities.

And the last point that interests many people who have undergone hip replacement, but what they are embarrassed to ask a specialist about: when is intimate life allowed? You cannot have sex until the unnatural joint is securely fixed in the bone structures and is thoroughly attached to the muscles and ligaments - the main “levers” that bring the prosthesis into a functional state. And this is possible, as we have repeatedly noted, after 90-120 days after prosthetics with a successful recovery.

Patients suffering from diseases of the spine and joints are wondering whether it is possible to go to the bathhouse with osteochondrosis. In folk medicine, bath procedures have always been considered a remedy for many diseases. But won't exposure to high temperature and hot steam lead to an exacerbation of the disease?

What are the benefits of steam?

Osteochondrosis is degenerative changes in the spine. The cause of the disease is a slowdown in metabolism in the cartilage. If the disease affects not only cartilage, but also bone tissue with muscles and ligaments, then spondyloarthrosis (spondylosis) occurs. Hot steam acts as an irritant that stimulates metabolic processes and promotes the rapid restoration of damaged cells. Therefore, osteochondrosis and the bath are compatible, it will be a good addition to the main treatment.

Hot steam treatments have the following effects on the body:

1. Under the influence of high temperature, the skin pores open, through which waste, toxins and other harmful substances are removed from the body.
2. Lactic acid is released through the pores, which often contributes to increased muscle weakness and fatigue. Usually after a bath a person feels cheerful and rested.
3. Dead epithelial cells are removed, resulting in the skin being renewed.
4. Massage with a broom made from plant branches improves blood circulation.
5. Bone tissue dystrophy always accompanies spondyloarthrosis and osteochondrosis; the bathhouse helps the cells recover.
6. Bath procedures strengthen the immune system and cleanse the body of harmful microbes.
7. Exposure to hot air improves the mobility of joints and ligaments.

When asked whether it is possible to take a steam bath with osteochondrosis, the answer from doctors is usually positive. Doctors recommend such procedures and use them in complex therapy of the disease. However, in some cases caution should be exercised.

Contraindications to bath procedures

In the bathhouse, the body is exposed to quite strong effects of high temperatures. Therefore, in some cases such procedures are contraindicated. Before visiting the bathhouse, you should consult your doctor. Only a specialist can tell you whether such a procedure will be useful. There are the following contraindications for visiting the steam room:

1. You should not be in a bathhouse if you have osteochondrosis and spondylosis in the acute stage. The attack must be relieved with the help of medications, and only when the manifestations of the disease subside can steam procedures be taken. A bath for acute back pain is not always useful; in such cases, exposure to heat can provoke inflammation. If spondyloarthrosis is accompanied by severe pain, it is better to avoid vaping.
2. It is not recommended to go to the steam room if you have a herniated disc.
3. If the patient has an elevated body temperature, then exposure to hot air is contraindicated. There is a widespread belief that in case of fever it is useful to take a steam bath, but a sick person will have great difficulty enduring the bath procedure.
4. Under no circumstances should you go to the bathhouse if you have heart disease or high blood pressure. This is very dangerous and can lead to heart attack and stroke.
5. You should not take a steam bath if you have kidney disease, especially with inflammatory processes. This causes a rush of blood to the excretory organs, which increases inflammation. In addition, due to increased sweating, diuresis decreases.
6. If hemoglobin is low, going to the bathhouse is contraindicated, since tissue hypoxia increases due to dilation of blood vessels.
7. Women should avoid bathing during menstruation and pregnancy.

If there are no such contraindications, then you can safely go and take a steam bath. A bathhouse for osteochondrosis will only be beneficial. Spondyloarthrosis is also not a contraindication for bath procedures. However, the advice, worry as much as you like, will be wrong.

There are certain rules for accepting the procedure; steam exposure must be dosed.

It is important to take into account the form of the disease. For example, in case of osteochondrosis of the lumbar region, effects on certain muscle groups will be useful, and in case of damage to the cervical spine - on others.

How to take a bath for osteochondrosis?

The steam room should not be visited after a heavy meal. This will put unnecessary strain on the heart. But you don’t need to go steaming hungry either. A light meal is allowed before the procedure. It is enough to eat a vegetable or fruit salad.

Is it possible to take alcohol with you to the bathhouse? Any doctor will tell you that this is completely unacceptable. In hot air conditions, alcohol can cause serious heart problems and even lead to a heart attack. In a hot room, a person is thirsty, but while in the steam room, liquid should not be consumed, you can only rinse your mouth. After completing the procedure, you are allowed to drink herbal tea, juice, fruit drink or mineral water. You should avoid drinking cold drinks: this can cause colds.

You need to prepare a broom, it is necessary for medical procedures. It is better to choose brooms made from coniferous trees, for example, juniper. If a patient is diagnosed with cervical osteochondrosis, treatment with a juniper broom bath will help reduce pain and stiffness. In addition, the resins contained in the needles have a beneficial effect on blood vessels and normalize blood pressure.

Is it possible to steam with osteochondrosis for a long time? This is not worth doing. If you stay in the steam room for 5-10 minutes, then this will be quite enough to improve the health of the body. Under no circumstances should you fall asleep in a steam room, as this can lead to heat stroke.

It is necessary to avoid sudden temperature changes and do not alternate dousing with hot and cold water. This may cause an exacerbation of the disease. There are many cases where patients took a steam bath and then were doused with cold water and received a severe pain attack. Such contrast procedures are good only for healthy people when hardening the body, but are strictly contraindicated for diseases of the spine.

The Finnish sauna is very helpful for patients with osteochondrosis. Hot air combined with low humidity is easier to tolerate.

A bathhouse for osteochondrosis of the cervical spine will be more beneficial if you lubricate your shoulders and neck with honey before visiting the steam room. Then you need to do the following:

1. Steam for 5-10 minutes. A light massage with a broom will be helpful. Movements should be light, from feet to shoulders. You can apply a hot broom to the affected areas.
2. After visiting the steam room, you need to cover yourself with a warm towel and drink hot herbal tea.
3. Then go to bed under a warm blanket.
4. A bath for cervical osteochondrosis can be completed with a massage with essential oils or badger fat.

If the lumbar region is affected, before visiting the steam room, apply an ointment prescribed by the attending physician. Then the procedures are carried out in the following order:

1. You need to enter the steam room for 10 minutes.
2. Then take a short break and visit the steam room again for 5-7 minutes.
3. After steaming is completed, you need to apply Vaseline and place 3 jars on the lumbar area. Even after a single procedure there is improvement. And after 3-4 sessions, symptoms such as pain and stiffness in the lower back disappear.

If you have osteochondrosis, you can steam while lying on the bottom shelf. This way the exposure to hot air will be more uniform. Of course, it is impossible to treat this disease only by visiting a bathhouse. It is necessary to take medications to help reduce pain, inflammation and swelling. In this case, steaming the body will be an additional method of therapy.

If the patient is diagnosed with spondyloarthrosis, then the rules for visiting the bathhouse are the same as for osteochondrosis.

Is it possible to go to the sauna with arthrosis?

Often with osteochondrosis, arthrosis of other joints is observed. Degenerative processes in cartilage tissue can occur in the hip, knee, elbow and other joints. Patients are interested in how compatible arthrosis and sauna are, and whether it is possible to take a steam bath after operations, for example, after hip replacement.

We can say that a bath is beneficial for joints. This procedure helps increase joint mobility and strengthen muscles. However, it is necessary to take into account some contraindications to visiting the steam room:

1. If arthrosis is in the acute stage, swelling and acute pain in the joint are observed, then you should not take a steam bath.
2. After hip replacement, you can steam six months after installing the prosthesis.
3. You should not steam joints during inflammatory processes, for example, arthritis, as well as rheumatism and acute spondylitis.
4. If a patient with arthrosis is prescribed a course of treatment with corticosteroids, then it is better to refuse to visit the bathhouse.

In the absence of these contraindications, we can talk about the compatibility of joint diseases and visiting a steam room.

You should consider the rules for taking paired procedures for various joint diseases:

1. A bath for arthrosis of the knee joint (gonarthrosis) will help increase the elasticity of the ligaments and remove salts. After visiting the steam room, you need to massage the sore area and put a warm compress with alcohol tincture on your knee. For gonarthrosis, you can lubricate the sore joint with oil, cover it with burdock leaves, tie it with a woolen scarf and leave it overnight.
2. After knee replacement, bathhouses and saunas should not be used for the first 2-3 months after the operation. Otherwise, this may provoke the development of thrombosis.
3. After hip replacement, the bathhouse is visited only after 6 months and very sparingly. It must be remembered that the endoprosthesis must be handled with extreme caution, since its parts are made of metal. You can stay in the steam room for no more than 4-5 minutes, otherwise the prosthesis may overheat. Even if the patient has a titanium joint implanted, exposure to high temperatures can damage the prosthesis. When visiting the steam room after hip replacement, you should cover your thigh with a warm cloth after the procedure. It is important to prevent hypothermia of the joint area.
4. Is it possible to go to the bathhouse with coxarthrosis of the hip joint? It is recommended to take paired procedures for this disease 5-10 times every 2 months. Like any other arthrosis, damage to the hip joint responds well to steam treatment. Exposure to hot air should last about 10 minutes. It is useful to lightly massage a steaming patient in the thigh area with a hot pine broom; this will help improve blood supply. A short massage session and swimming after the bath will improve blood circulation.
5. Arthrosis of the shoulder joint is also an indication for thermal procedures. After steaming, you can massage your shoulder with healing oils.

In the bath for arthrosis of the joints, it is useful to use medicinal decoctions of rose hips, wild rosemary, pine buds, and black currants. These liquids are poured over hot stones.

When evaporated, essential oils are released, which help expand pores, remove toxins and relieve pain.

We can conclude that the bath is useful for osteoarthritis. You just need to observe the measure and not expose the body to unnecessary overheating. Before taking procedures, you should consult your doctor to make sure there are no contraindications.

Of all types of baths, the sauna has the greatest therapeutic effect. In accordance with the microclimatic regime, it is dry-air because it combines high air temperature (70–90 °C) and low humidity (5–15%) in a thermal chamber. Subsequent cooling occurs in water or air at relatively low temperatures. Cooling rooms can be a shower room, a swimming pool or an air cooling room. In addition to hygienic cleansing of the body and cosmetic effect, the sauna has a pronounced physiological effect on the human body. Chlorides, urea, creatine, ketone bodies, lactic acid, salt ions and some amino acids are released with sweat. There is a partial release of the body from metabolic products. This facilitates the filtration function of the kidneys. The use of dry air baths accelerates the renewal processes of cell proteins. Nutrition stimulation and tissue regeneration occur. Basic metabolism after a sauna increases by 20–24%, tissue respiration increases by 1.5–2.5 times, and the degree of oxygen utilization by tissues increases by 30–60%. When the body warms up, the production of interferon and antibodies in tissues increases, biochemical processes intensify, increasing the immunobiological and protective forces of the body. Hyperthermia contributes to the death of pathogenic flora on the skin and mucous membranes and in internal organs. Optimal temperature conditions and duration of stay in the sauna lead to improved indicators of the functional state of the central nervous system and musculoskeletal system. The light sensitivity of the eye increases by 40%, the speed of motor reaction to light and auditory signals increases by 7 and 8%, respectively, the accuracy of movements increases by 26%, and the endurance of the back muscles increases by 14%. There is no doubt about the positive effect of the sauna on mental status. The sauna increases emotional tone, improves sleep, and has an anti-stress and sedative effect. Thanks to the effect on the musculoskeletal system, the following results are achieved: functional indicators improve (flexibility, mobility); performance is restored and increased; the elimination of metabolites formed as a result of muscle activity is accelerated. Among the contraindications to the procedure, the following should be noted first: acute diseases accompanied by an increase in body temperature; acute compression radicular syndromes; acute rheumatic diseases with signs of process activity; acute traumatic injuries; active corticosteroid therapy; infectious diseases; psychoses and psychopathy; malignant tumors; circulatory failure; respiratory failure degree II. The air temperature in the heat chamber at the level of the top shelf should be 75–78 °C, the relative air humidity should be maintained at 10–15%. Temperatures above 85 °C are not recommended, as this leads to overload of the cardiovascular and other systems. It is advisable to visit the sauna no more than 2 times a week. Each procedure includes three visits to the thermal chamber (Table 4): 2 times for 7–8 minutes and 1 time for 4–5 minutes with an intermediate rest (5 minutes) when water procedures are taken (pool with water temperature 31–34 °C, comfort shower), and a final rest of 30 minutes, during which they drink warm tea. Patients with rheumatism may experience undesirable reactions when cooling due to increased sensitivity to cold, so the temperature of the cooling environment should be close to body temperature, and in the heat chamber - no higher than 75 °C. The procedure should be shortened in time, as swelling of the legs and muscle weakness may develop. In patients receiving corticosteroids (including those administered intra-articularly), visiting the sauna is allowed no earlier than 2-4 weeks after discontinuation of these drugs. Patients with joint pathology often have an increased reaction to changes in meteorological conditions. The sauna is one of the methods that allows you to reduce this reaction and increase adaptation to changing environmental conditions. Osteoarthritis of the hip and knee joints is characterized by damage to the articular cartilage. To improve its nutrition, it is necessary to increase the blood supply to the bone and joint. The cartilage itself does not have blood vessels, and receives nutrients from the synovial fluid. If, as a result of osteoarthritis, muscle hypotonia, limited range of motion, and contractures have developed, then a sauna is prescribed for up to several years. Active movements in the pool - swimming, therapeutic exercises - will help improve mobility. A visit to the sauna is indicated after hip replacement to prevent postoperative phlebitis of the deep veins of the legs. In this case, it is recommended to visit the sauna 3 months after the operation. If there is radiologically proven activity of osteoporosis, the sauna is contraindicated. You need to stop visiting the sauna until the process subsides. The sauna can be prescribed in almost all stages of gout, as it increases the secretion of uric acid through sweat, which relieves the kidneys and prevents the formation of stones.

Infrared sauna

Recently, infrared saunas have appeared. The advantages of such devices are compactness, efficiency, and ease of use. All they need is to find a place to put the cabin and an outlet for the sauna to work. The microclimatic regime of the procedure is different here: the temperature, as a rule, does not rise above 60 °C, and therefore there are differences with the Finnish sauna. The procedure consists of one pass for 20–40 minutes, followed by a cooling phase. At the same time, there is no such pronounced systemic reaction as in a Finnish sauna, which is preferable for people with problems with the cardiovascular system. Infrared rays warm the body, penetrating to a depth of 5 cm, accelerating local blood flow. Tissues located close to the surface of the skin warm up better. In addition, in infrared cabins, the emitters are located in several places at once, warming the body more evenly. The effect of increasing adaptation to changes in the external environment, training the cardiovascular and respiratory systems in an infrared sauna is less pronounced.

Russian bath

The steam room has long been considered one of the effective hygienic, preventive, restorative and therapeutic means. The air temperature in a Russian bath reaches 50 °C with a relative humidity of 90-100%. It often involves whipping the body with a broom, which is similar to percussive massage techniques. Under the influence of hot air and whipping, the elasticity and mobility of the ligamentous apparatus improves. Soreness and muscle strain after physical strain, pathological deposits in the joints are easily eliminated. Tapping with a broom and temperature effects cause a redistribution of blood flow, increasing blood flow to the joints, which accelerates recovery processes, activates the formation of synovial fluid, and prevents the aging of cartilage tissue. The bath is used in the treatment of sprains, bruises and dislocations. Contraindications for a Russian bath are the same as for a sauna. In a Russian bath with high air humidity and difficult gas exchange, the human pulmonary circulatory system experiences even greater stress than in a sauna. High humidity also makes it difficult for sweat to evaporate. Due to increased metabolic processes in the body, as well as blood circulation, internal heat production increases, which entails overheating of the body. Therefore, you do not need to sit for more than 10 minutes in the steam room. 2-3 passes lasting 5-10 minutes are recommended, one of them with a broom. Brooms for baths for diseases of the back and joints. Birch broom- the most common in Russia. It helps with rheumatic and gouty arthritis, pain and aches in muscles and joints. Essential oil, tannins, vitamin C, and provitamin A were found in birch leaves. A broom is prepared from curly birch, since its branches are more flexible, dense, and the leaves do not become slippery when exposed to steam. A particularly flexible broom is obtained from trees growing near water. The surface of the leaves should be velvety to the touch. Eucalyptus broom used for neuralgia, muscle inflammation, bruises, sprains, joint pain. It is better to cook broom in August. Its disadvantage is that the branches are too thin, but this can be corrected by adding eucalyptus branches to a birch or oak broom. Nettle broom treat lower back pain, aching joints, radiculitis, rheumatism, gout. It contains a lot of ascorbic acid and iron. You need to know how to cook it correctly. The best time to harvest a broom is May-July. Before use, transfer the broom from hot water to cold water 2 times for 2–3 minutes; for medicinal purposes, place it in boiling water for 1–2 minutes. Juniper broom used in the treatment of neuralgia, radiculitis. But you need to get used to it, as it “stings” more strongly than nettles. Ash broom helps with rheumatism, radiculitis, arthritis. Ash leaves contain a lot of essential oil, carotene, and ascorbic acid. How to steam with a broom correctly? General rules: movements should be soft, smooth, you should barely touch the body with a broom; the broom should always be slightly damp; if the temperature in the steam room is high, then the movements with the broom should be slow, and vice versa, if the temperature is low, then the broom can be used more intensely. There are various methods for using brooms in a steam room. Let's consider one of them. 1. Starting position: lying on a shelf on your stomach. Lightly stroke with a broom from the feet to the head 3-4 times. Next is tapping the back with a broom with stroke-like movements in different directions. Then move on to the lower back, pelvis, hips, legs and feet. Lightly stroke the entire body again, touching it with a broom. Roll over onto your back and repeat in the same sequence on the other side. 2. Starting position: lying on your stomach. Lift the broom up (capturing the hot steam) and whip along the sides of the back 2-3 times, then press the broom to the body for 2-3 seconds (the so-called compress). The same is repeated on the lower back, buttocks, thighs, injured or overstrained areas. 3. Using a second broom, you can stretch. To do this, the brooms must be placed on the lower back and spread in different directions: one upward, the other downward. After 4-6 movements, stroke.

You have been offered endoprosthetic surgery, and you have no choice. Trust the doctors, their experience and competence. But you should also be aware of the complications that may arise during or after such an operation.

Fortunately, postoperative complications from endoprosthetics are low.

There are two most dangerous complications of endoprosthetics, depending on the experience of the doctor, and one - on the discipline of the patient

• Infectious process in the area of ​​the endoprosthesis (frequency 0.5-2%)
• Pulmonary embolism (fatal complication, incidence less than 0.05%)
• Danger of endoprosthesis dislocation

Infection in the area of ​​the endoprosthesis is a serious complication. To avoid this, you will be given antibiotics before surgery and will continue to be given them for 24 hours after surgery. This procedure will prevent germs from entering the wound directly during surgery. Infection in the area of ​​the endoprosthesis cannot be treated, and the infectious process can be stopped only after removal of the endoprosthesis. You need to know that the risk of developing an infectious process may be increased in patients suffering from concomitant diseases such as rheumatoid arthritis and osteoarthritis and constantly taking hormonal medications.

Pulmonary embolism is the most severe complication of endoprosthetics, which leads to death. The reason for this lies in the fact that after endoprosthetics, patients’ ability to form blood clots sharply increases. If such a thrombus breaks away from the wall of a blood vessel and enters the lungs with the bloodstream, the process of oxygen supply to the body is disrupted, and the patient dies. Modern medicine has a wide range of highly effective drugs that prevent the development of thromboembolism. All patients after endoprosthetics are given anticoagulants, special medications that “thin” the blood. As a result, blood clots do not form and the risk of thromboembolism is sharply reduced. Anticoagulants must be taken for 2-3 weeks after surgery.

Danger of dislocation of the endoprosthesis. In order to prevent this complication, the patient must observe the following restrictions in the first 6 weeks after surgery:

• do not bend the operated leg at the hip joint more than 90 degrees
• Lie in bed only on your back or healthy side with a pillow between your legs
• do not turn the operated leg with the toe inward

Rehabilitation activities

Postoperative complications can be avoided if you follow the doctor’s recommendations and carry out all rehabilitation measures.

• In the first 2-3 days, you need to walk around the ward with the help of a walker, then gradually increase the duration of walks.
• After about 5-7 days, instead of using a walker, it is tedious to switch to walking with crutches, still limiting time and distance.
• 10-14 days after joint replacement, when you are discharged from the hospital, you can walk confidently with crutches.
• At home, you need to perform simple physical exercises every day, which were taught by your doctor.
• Continue taking blood thinning medications for 3-4 weeks after endoprosthetics.
• Walking with full weight bearing on the leg is allowed 1-1.5 months after cemented endoprosthetics and 2-2.5 months after cementless.

The total rehabilitation period depends on the patient’s age and the characteristics of endoprosthetics. On average, it is about 3-4 months. After this time, most patients return to normal life.

Strictly prohibited!

• For patients who have undergone endorothesis surgery, any physical procedures on the operated area are contraindicated: electrophoresis, magnet, UHF, heating, mud therapy, etc. These effects are in no way capable of improving the functioning of the artificial joint and should not be used at any time after surgery.
• After endoprosthetics, you cannot sunbathe or visit the sauna or bathhouse. Excessive exposure to heat on the operated joint can cause internal inflammation of the soft periarticular tissues, which is very difficult to treat.

Feel free to go for endoprosthetics surgery. Follow all doctor's recommendations. Be healthy and happy!